Tracheal intubation through a laryngeal mask airway is an alternative to secure the ventilation in patients with difficult airway. Different techniques have been described to intubate these patients. A case of micrognathia in remote location anesthesia is reported. Endotracheal intubation was unsuccessful with the conventional methods. A soft tip angiography guidewire was advanced through a laryngeal mask airway. The position of the catheter was confirmed by fluoroscopy. Laryngeal mask airway was removed after endotracheal tube was inserted over the guidewire. This technique is recommended as an alternative where fiberoptic bronchoscopy is unavailable and in emergency situations.